Provider Demographics
NPI:1598733636
Name:LUTZE, LYNNE MARIE (PHD,LMHC, LPC, NBCC)
Entity type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:MARIE
Last Name:LUTZE
Suffix:
Gender:F
Credentials:PHD,LMHC, LPC, NBCC
Other - Prefix:
Other - First Name:LYNNE
Other - Middle Name:M
Other - Last Name:LUTZE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:184 BRYN DR
Mailing Address - Street 2:
Mailing Address - City:PEOSTA
Mailing Address - State:IA
Mailing Address - Zip Code:52068-9111
Mailing Address - Country:US
Mailing Address - Phone:563-451-7677
Mailing Address - Fax:
Practice Address - Street 1:7407 THUNDER VALLEY DR
Practice Address - Street 2:
Practice Address - City:PEOSTA
Practice Address - State:IA
Practice Address - Zip Code:52068-9475
Practice Address - Country:US
Practice Address - Phone:563-451-7677
Practice Address - Fax:319-305-3375
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3880-125101YP2500X
TX91832101YP2500X
IA#00819101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1124415740OtherNPI